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oil is packed into the socket.
15 Application of ozone as opposed
to saline irrigation reduces postoperative pain and the potential
for dry socket. Recovery periods for patients treated with ozone
have proved to be shorter due to the formation of pseudomem-branes in sockets that provide protection from mechanical or
Oral lesions such as aphthous ulcers, herpes, candidiasis, lichen planus, and angular cheilitis are common conditions seen
in the dental practice. Since these lesions result from bacterial,
fungal, or viral means, ozone is a useful treatment option. Topical application of ozonized olive oil was studied on patients with
oral lesions and showed 100% cure rates with no adverse side
17 This method may be preferred over gaseous ozone in
that patients can use the oil at home when a lesion arises, saving
them the additional cost of a dental visit.
Tooth sensitivity is a common problem for many patients. It
can cause frustration not only for the patient but also for the
dentist or hygienist trying to alleviate the symptoms. Even after
application of a variety of desensitizing agents or placing restorations over sensitive areas, patients may still have lingering
sensitivity. As treatment methods become more invasive, the
potential for increased sensitivity rises. Ozone therapy in combination with remineralizing agents can deactivate the stimulus
causing the pain and allow remineralization deep into the tubules.
18 Results from a clinical trial of patients with hypersensitive teeth treated with gaseous ozone for sixty seconds showed
pain reduction of 55% immediately after treatment. Pain levels
continued to decrease in the weeks following ozone treatment.
Due to the multifactorial nature of dental sensitivity, anecdotal
evidence supporting the efficacy of ozone in reducing or eliminating tooth sensitivity should be given due consideration.
The oral environment is host to many complex bacteria that
develop into communities and form a biofilm on solid surfaces. The aim of periodontal therapy is to remove biofilm and
prevent the recolonization of pathogens in the treated areas.
Conventionally this is done by scaling and root planing of the
periodontal pockets and then subgingival irrigation with antimicrobial agents.
20 Ozone has been found to be an effective
nonmedication treatment option for periodontal therapy. A
2015 study concluded that subgingival irrigation with ozonized
water reduced gingival inflammation, decreased pocket depth,
increased attachment levels, and reduced bacterial count in
21 To eliminate biofilm in the oral cavity is
impossible, but disinfection of the biofilm with ozone is possible in combination with scaling and root planing.
Just as biofilm forms on surfaces in the oral cavity, it also forms
in the lines of dental water units. These water lines harbor
bacteria that can be harmful to patients and the dental team.
The biofilm buildup in water lines can be thick and is enclosed
in a protective layer that makes it resistant to chemical agents.
Since the majority of dental procedures require water, this is a
real concern for the dental practice. Traditional agents used to
eliminate bacteria in these lines are effective for bacteria that
are suspended in the water but not on the biofilm layer.
is widely accepted in the sterilization of public water systems,
so its efficacy in treating dental water lines would be advan-
tageous. In a study investigating the effectiveness of ozone in
controlling the contamination of dental water lines, the initial
bacterial count was just above 5,000 CFU/ml. After the first
three-minute application of ozone and flushing of the water
line, the bacterial count was reduced to 300 CFU/ml, and then
to O CFU/ml after the second and subsequent applications.
For five weeks after ozone treatment, the lines continued to be
23 This dramatic reduction in the bacterial count and its
long-term sterility demonstrate the usefulness of ozone in the
treatment of dental water unit lines.
Special considerations of ozone treatment
Misuse of any pharmaceutical agent can have adverse or lethal
effects to one’s health. To ensure the safety of practitioners and
patients, ozone in the dental practice should be administered
only by trained professionals in controlled applications. Safety
limits set by the Occupational Safety and Health Administration of “0.10 ppm of ozone exposure for an 8-hour-day”
should be monitored and enforced. Ozone gas should never
be inhaled due to the sensitivity of the bronchial pulmonary
25 Use of high-volume suction and proper ventilation is
essential to protect both patient and operator during treatment.
Ozone is an excellent adjunct to all aspects of dentistry. Its effectiveness in disinfection and healing make it a therapy that
contributes to the success of dental procedures. Patients are
receptive to ozone because it is minimally invasive, shortens
appointment times, and in most cases requires no anesthetic.
Ozone research has opened up the way for exciting new treatment protocols that have not been taught in dental schools or
clinical training and may change the way we treat patients in
1. Naik SV, Kohli S, Zohabhasan S, Bhatia S. (2016).
Ozone—a biological therapy in dentistry—reality or
myth? The Open Dentistry Journal, 196-206. Retrieved
February 7, 2017 from https://www.ncbi.nlm.ni
2. Roman M. (2013). Ozone therapy in veterinary practice.
IVC Journal, V314. Retrieved May 14, 2017 from https://